Keeping the Weight Off

Losing weight isn't the toughest part of the diet wars; keeping the weight off permanently is. Here's how to do it.

By Kristyn Kusek Lewis

How to Keep the Weight Off -- for Good

We've all been there: You lose weight for a personal resolution or special occasion, and you feel empowered and encouraged. But before you know it, diet and exercise become the balls you can't keep in the air during your daily juggle, and the scale creeps back up to that number you thought you'd seen the last of.

Study after study finds that the majority of dieters regain everything they've lost -- and often more. Unfortunately, this struggle only proves harder as time goes by. "As we age, we start to lose our muscle mass, which slows metabolism," says Donald Hensrud, MD, of the Mayo Clinic in Rochester, Minnesota. "In women, weight maintenance can be especially difficult after 40 because the estrogen loss associated with menopause leads to a tendency to gain more weight around the middle."

So what does it take to lose weight and keep it off? That's what researchers for the National Weight Control Registry have been investigating for more than a decade. Its database includes 6,000 people who've lost at least 30 pounds and kept them off for a year or more. We talked to 10 women, ranging in age from 42 to over 60, who've used NWCR's successful techniques (along with creative approaches of their own) to slim down for good.

"I limit the variety of foods I eat."

Cynthia McKay, 53, Parker, Colorado

Lost: 25 pounds

Maintained for: 19 months

As CEO of a gourmet foods company, McKay is surrounded by temptation. Her solution is to eat several small meals of the same few satiating combinations of protein and healthy carbs every day. Breakfast is fruit and yogurt or whole-grain Cheerios and skim milk. Daytime meals include canned tuna on a whole wheat roll, small portions of cheese and fruit, or a low-fat cookie and skim milk. Dinner is a sensible portion of whatever she wants -- even two slices of pizza.

Call it the Groundhog Day approach: A University of Buffalo review of 58 studies concluded that eating fewer foods or flavors bores the taste buds, leading to satisfaction with less. The reverse is also true: When offered several flavors or a new flavor, we overeat, which is why it's so easy to make room for dessert even on a full stomach.

One NWCR study found maintainers also restrict the variety of high-fat treats they consume. If you limit your junk food quotient to just a couple of foods (say, nacho chips and mint chocolate chip ice cream), the lures aren't endless.

"I weigh myself every day."

Jennefer Witter, 46, The Bronx, New York

Lost: 30 pounds

Maintained for: 16 years

"I was thin until I turned 30, when I seemed to put on 30 pounds overnight," Witter says. "I even accused my dry cleaner of shrinking my clothes!" She lost the weight by working with a nutritionist, and weigh-ins after her 30-minute cardio and weight-training sessions have kept her trim since. "I get on the scale virtually every morning," she says. NWCR members say regular self-weighing is crucial: 75 percent climb on the scale at least once a week, and half weigh in daily. "People try to track their weight by how their clothes feel, but by the time your pants are tight, you may have gained 10 pounds," says NWCR cofounder Rena Wing.

The key to daily weighing is not to overreact. Your weight can fluctuate by up to four pounds on any given day. Instead, notice patterns: "I don't freak out if I'm suddenly two pounds up. But if the number steadily climbs, I add 10 extra minutes of cardio to my workout until the weight comes back down," Witter says.

"I moved to the city."

Anne Lewis, 58, Baltimore, Maryland

Lost: 14 pounds

Maintained for: Three years

A few years ago, Lewis and her husband left rural Minnesota for a high-rise in Baltimore, where a harbor promenade starts right outside their front door. The unintended but much welcomed side effect was a 14-pound loss. "In the country, I could just let the dog out the back door," Lewis says. "Now I have to walk her, so we do two-and-a-half miles every morning." Being less dependent on a car also makes a big difference: "Now we walk to dinner instead of driving everywhere -- why bother dealing with parking?" she says.

The neighborhood-waistline link is an emerging area of obesity research. A 2003 study found that people who live in the most walkable communities are on average six pounds lighter than those in the most sprawling suburbs. Another survey of nearly 11,000 Atlanta residents found that those who spent the most time in cars were more likely to be obese than those who walked to shops and offices. "Traveling by foot is a painless way to keep weight off," Hensrud says.

"I plan ahead."

Lisa Skiles, 44, Evansville, Indiana

Lost: 102 pounds

Maintained for: Six years

For most of her adult life, Skiles struggled against what people called her big-boned frame. Since losing weight with the help of a diet program, she has maintained her impressive loss through careful planning. Rule one: She decides what she'll eat that day when she gets up in the morning. "Lunch with a friend means I'll eat more than normal, so I'll plan on a light dinner," Skiles says.

Skiles also knows her order before she walks into a restaurant, so the menu doesn't tempt her. And she fits in a few higher-calorie choices too: "If I want dessert, I skip the refined carbs at my main meal."

Judith Beck, PhD, author of The Beck Diet Solution, says spontaneous eating may mean you'll choose foods based on cravings, which usually means higher-calorie foods. Eating small portions of favorite foods is also key, according to Beck, 53, who has maintained a 15-pound weight loss for 10 years: "I like a treat at night, so I allow myself up to 250 calories of whatever I want. The trick is limiting it to after dinner, which motivates me to eat healthy the rest of the day."

"I hired a weight-loss coach."

Debbie Chabot, 48, West Dover, Vermont

Lost: 11 pounds

Maintained for: One year

Chabot tried every weight-loss scheme imaginable, and then she found a diet coaching service online. During weekly 30-minute phone calls, her coach helped her identify unhealthy eating patterns and gave her a safe place to talk about her insecurities regarding her weight. Before that, "I never had a person who cheered on my successes or guided me if I got off track," says Chabot, who still checks in with her coach every week or so.

Having a cheerleader can be a big asset for weight maintenance. A new study found that dieters who had social support from family and friends lost more weight over an 18-month period than those who didn't.

"I slowly ramped up my exercise routine."

Leslie Adler, 42, Jericho, New York

Lost: 20 pounds

Maintained for: 10 years

"I'm not a salad-every-day person. I live to eat," Adler says, who lost weight by focusing on exercise instead of diet. "I was a jock growing up, so after I had kids and attempted to start exercising again, I thought I could go from zero to 60. I'd get so frustrated with how out of shape I was that I'd quit. What worked for me was starting out just two days a week and moving steadily from there."

Adler began by jogging with her husband, graduating from around the block to five-mile runs. Then she joined a gym and worked with a trainer. Now she combines twice-a-week weight training with a cardio free-for-all the rest of the week: "We're big on two-on-two basketball in the driveway," she says.

Daily activity is essential: 91 percent of NWCR participants exercise for an hour a day, usually walking. If you don't exercise, start with 10-minute walking sessions until you've built up to 30 minutes every other day. Once you're in the habit, revamp every six weeks by varying the routine: work out at a more intense pace, or try a new activity.

"I found out exercise can be fun."

Lisa Trapani, 45, Westminster, Maryland

Lost: 40 pounds

Maintained for: One-and-a-half years

When Trapani decided to lose weight, she needed to get physical. "It occurred to me that when I was a kid, I loved running around, but as an adult, I'd come to see moving my body as a self-conscious thing. I decided that if I thought of exercising as a way to blow off steam, I might enjoy it."

Although Trapani has made some tweaks to her diet -- eating a healthy breakfast and downsizing her dinner -- her primary focus has been on exercising at least 30 minutes a day. She has been surprised to discover her new workout is her favorite part of the day. When she's on the treadmill, she blasts Madonna. Trying new exercise videos, she found that she loves Pilates. Her bottom line: Keep workouts fresh so you'll stay at it, then reap the rewards.

Everyone can find something they enjoy doing that gets them to move more, says Jay Ashmore, PhD, of the Cooper Aerobics Center, in Dallas. "One of my clients loves art," he says. "So we have her do her walks in museums and gardens. She gets her physical activity needs met by doing something she loves, and she's lost 50 pounds."

"I pamper myself."

Dee Wolk, 62, Cleveland, Ohio

Lost: 42 pounds

Maintained for: 24 years

Wolk stayed on the lose-gain roller coaster until her 30s, when she realized she knew a lot about dieting but not about emotional eating. "I ate because I was tired, bored, angry, happy, had worked hard or not enough," she says. "I needed to learn how to take care of myself without food."

She figured it out, and now she teaches her technique at the Cleveland Clinic, among other places. Her favorite trick is to treat herself to something every day, filling the emotional void she used to stuff with food. "Sometimes it's calling an old friend, and sometimes it's taking off my bra and putting on a comfy old robe," she says.

But is a soothing bath a satisfying substitute for a banana split? "The more you treat yourself, the more you reinforce the good habits and weaken the bad one," Beck says.

"I eat several small meals a day."

Michaela McKenna, 43, Scottsdale, Arizona

Lost: 50 pounds

Maintained for: One year

McKenna felt heavy and dumpy. So while her husband of 22 years was on a yearlong work assignment overseas, she lost 50 pounds by enrolling in a diet program.

Eating small amounts of food several times a day has kept the weight off. "In the past, I'd be too busy to eat until the afternoon," McKenna says. "Then, when the kids came home from school, I'd start grazing. I'd eat 4,000 calories by bedtime." Now her daytime food choices consist of yogurt and a handful of almonds, or a high-protein cereal bar and fruit. At dinner she eats a small portion of whatever her family is having, such as fish and whole wheat pasta. Eating frequently keeps her blood sugar level even, so she doesn't have the energy highs and lows that used to lead to cravings. If you graze throughout the day, make sure to keep the quantity per sitting to a minimum, says Molly Kimball, RD, of the Ochsner Clinic's Elmwood Fitness Center, in New Orleans. "Aim for 200 to 300 calories per meal, about every three to four hours."

"I keep a food diary."

Doris Lancaster, 49, Cedar Hill, Texas

Lost: 65 pounds

Maintained for: One year

Lancaster lost weight through a program sponsored by her local hospital. Her secret weapon is her food diary. On FitDay.com, a free, private online log, she keeps track of everything she puts in her mouth. "It's tedious, but I know if I have a milk shake, it's going on my permanent record," she says. The diary has also helped her identify eating patterns and triggers, and knowing what drives her to overeat or crave unhealthy foods makes her less likely to succumb.

"The number-one reason people regain weight is because they stop monitoring their behavior in the careful way they did while they were losing," Kimball says. "Most research on food diaries has found that they help people maintain their loss."

Weight-maintainers may record every day, once a week, or when they notice weight creep. A simple notebook is fine, but some online programs can calculate calories and nutrients. (Dietorganizer.com features software for PDA devices.) Just don't get lost in the details: Tracking what you ate, the portion size, and how you were feeling ("rushed," "bored") is sufficient.

The Skinny on Weight-Loss Coaching

Weight Watchers meetings were once the gold standard of diet support, but now you can seek virtual advice. Many Web sites claim to help members shed pounds. You need to investigate them with a discerning eye, and be wary of programs that peddle supplements. Some coaching services are free; others can cost hundreds of dollars a month. Here are some smart slim-down choices.

Internet support groups

Want to commiserate without climbing on a scale in public? WeightWatchers.com is based on the same program that you get in a traditional walk-in setting, with support from fellow dieters available via their online message boards ($29.95 sign-up fee; $16.95 a month). And eDiets.com, which Consumer Reports recently rated as one of the most effective online diet programs, provides a virtual community of 125 support groups (such as ones for forty-somethings and working moms). It can also partner you with someone who has similar fitness goals ($18 monthly).

Virtual Experts

Other sites go beyond the buddy system and offer advice from certified nutrition experts. Diet.com features customized weight-loss programs and has registered dietitians and other health professionals who monitor support-group chats and answer questions via e-mail ($2.29 to $4.99 per week). TrimTalk.com, the program Debbie Chabot used, has a board of medical experts, who train its counselors ($29.95 per 30-minute session).

DIY support

If you can't find an online network you like, create your own. Recruit your own team of two to 10 people, and join the Live Healthy America 100-Day challenge. You'll go up against other teams to lose weight, eat healthy, and get fit. To sign up, go to livehealthyamerica.org. You can also invite friends to join a discussion group on Google or Yahoo.com, or find a diet buddy on the MORE.com message boards.